| NPI | 1760571749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 170) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WV AP00451184) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |